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AHRQ Advocacy

Multisociety Pain Workgroup Continues Dialogue with AHRQ

In response to a letter from Dr. Elise Berliner, PhD, Director of AHRQ’s Technology Assessment Program, the Spine Intervention Society along with the thirteen other MPW specialty societies, responded in turn. The letter expresses the continued concerns regarding the methodological flaws and resulting erroneous conclusions of the technology assessment which poorly serve physicians and patients and may inadvertently cause harm. SIS coordinates the Multisociety Pain Workgroup (MPW)’s work on highlighting important research considerations in support of spinal injections.

A letter to the editor was submitted on September 22, 2015 to the Annals of Internal Medicine regarding the systematic review and meta-analysis published on September 1st by the same team that produced the AHRQ’s recent technology assessment on pain management injections for low back pain, presenting the same data and conclusions. SIS coordinates the Multisociety Pain Workgroup (MPW)’s work on highlighting important research considerations in support of spinal injections.

On July 29, 2015, the International Spine Intervention Society joined 13 other medical specialty societies in sending a letter to Elise Berliner, PhD, Director of AHRQ’s Technology Assessment Program. The letter addresses concerns regarding the recently published AHRQ technology assessment Pain Management Injection Therapies for Low Back Pain. The letter requests that due consideration be given to these concerns, and that several aspects of the report be revisited to ensure that the best available evidence is addressed scientifically in order to provide an accurate assessment of the procedures reviewed. The letter is available here and will be submitted for publication shortly.

Despite the best efforts of the International Spine Intervention Society to provide extensive comments, suggestions, and references in response to the Agency for Healthcare Research and Quality's (AHRQ) draft Technology Assessment on Pain Management Injection Therapies for Low Back Pain, the report has been published without rectifying significant flaws in the report's methodology, interpretation of study results, and conclusions.

International Spine Intervention Society leadership is disturbed by the authors' dismissive responses to robust, critical comments aimed at obtaining an accurate assessment of the state of the evidence. We encourage our members to review the report, which will likely be used by Medicare and private payers to inform decisions relative to coverage decisions for injection procedures -- many of which, contrary to the report's conclusions, are very effective tools in the treatment of appropriately-selected patients.